Health Outcomes

The AHS regularly links the cohort to State Vital Statistics and Cancer Registries to update mortality from all causes and cancer incidence. Other health endpoints are collected by self-report in periodic follow-up questionnaires. Specific health endpoints of interest are confirmed through additional participant contact, review of medical records, and, as required, clinical exam.

Table 2a: Applicator Post-enrollment (Incident only) Malignant Cancer Cases by Site and Data Collection Progress 1,2,3,4,5
Cancer Site Total with Cancer Completed Phase II QX Completed Phase III QX Returned Buccal Sample Returned Dietary History QX
Bladder 544 381 287 278 250
Brain 177 58 33 38 36
Breast 73 50 37 26 25
Bronchus and Lung 1,025 569 330 316 303
Colon 753 490 339 320 278
Head and Neck 108 68 48 42 36
Kidney and Renal Pelvis 426 257 186 173 159
Leukemia 355 222 157 160 137
Liver and Intrahepatic Bile Ducts 97 52 30 22 29
Melanoma 546 370 278 223 213
Mesothelioma 26 11 9 6 5
Multiple Myeloma 180 124 70 80 79
NHL 477 312 234 249 186
Oral 232 162 118 103 102
Ovary 14 9 6 2 3
Pancreas 251 145 91 69 74
Prostate 3,824 2,701 2,160 2,099 1,596
Rectum and Rectosigmoid Junction 312 203 133 128 117
Stomach 136 85 57 55 54
Thyroid Gland 107 63 50 39 26
Uterine 11 8 6 3 3
Other 817 518 353 324 312
All 10,431 6,858 5,012 4,755 4,023

1 Cancer counts are based on complete registry data through 2019 for Iowa cases and through 2014 for North Carolina cases.

2 Subjects previously diagnosed with cancer at a different site are included.

3 Buccal cell receipts represent progress through 2014.

4 The 'Other' category includes in-situ bladder cancers.

5 SEER Site Recode ICD-O-3 (1/27/2003) Definition used for classifying cancers.


Table 2b: Spouse Post-enrollment (Incident only) Malignant Cancer Cases by Site and Data Collection Progress 1,2,3,4,5
Cancer Site Total with Cancer Completed Phase II QX Completed Phase III QX Returned Buccal Sample Returned Dietary History QX
Bladder 85 63 53 47 48
Brain 65 44 30 37 34
Breast 1,725 1,348 1,143 995 949
Bronchus and Lung 342 245 145 158 168
Colon 339 255 186 177 183
Head and Neck 11 6 5 4 3
Kidney and Renal Pelvis 127 90 81 61 62
Leukemia 111 74 64 48 43
Liver and Intrahepatic Bile Ducts 27 21 18 11 15
Melanoma 231 181 151 105 120
Mesothelioma 5 2 2 1 1
Multiple Myeloma 72 50 46 34 33
NHL 217 159 130 122 110
Oral 72 56 46 38 39
Ovary 148 108 81 66 68
Pancreas 109 72 53 42 47
Prostate 13 9 7 6 6
Rectum and Rectosigmoid Junction 86 66 55 45 45
Stomach 34 24 19 18 18
Thyroid Gland 152 123 97 83 77
Uterine 449 342 290 195 224
Other 377 289 215 177 200
All 4,797 3,627 2,917 2,470 2,493

1 Cancer counts are based on complete registry data through 2019 for Iowa cases and through 2014 for North Carolina cases.

2 Subjects previously diagnosed with cancer at a different site are included.

3 Buccal cell receipts represent progress through 2014.

4 The 'Other' category includes in-situ bladder cancers.

5 SEER Site Recode ICD-O-3 (1/27/2003) Definition used for classifying cancers.


Table 3: Cause Specific Mortality of AHS Cohort, 1994-2018
Cause Frequency Percent Cumulative Frequency Cumulative Percent
Accidents 914 5.04 914 5.04
Cancer 5,577 30.74 6,491 35.78
Cerebrovascular Disease 978 5.39 7,469 41.17
Diabetes Mellitus 473 2.61 7,942 43.78
Heart Disease 4,898 27.00 12,840 70.78
Respiratory Disease 1,522 8.39 14,362 79.17
Other 3,778 20.83 18,140 100.00

Table 4: Medical Conditions asked about in Phase II 1
  Private Applicators
N=52,394
Spouses
N=32,346
Commercial Applicators
N=4,916
Total
N=89,656
Completed Phase II Questionnaire 33,457 23,796 2,885 60,138
Cardiovascular Disease
Heart Attack (Myocardial Infarction) 1,789 370 122 2,281
Irregular Heart Beat (Arrhythmia) 3,267 2,571 243 6,081
High Blood Pressure or Hypertension 8,637 5,954 870 15,461
Endocrine Disorder
Diabetes or High Blood Sugar 2,429 1,314 188 3,931
Thyroid Disease or Thyroid Problems 1,075 2,947 90 4,112
Overactive Thyroid (Hyperthyroidism) 279 659 N/A 4 938
Graves Disease 62 151 N/A 4 213
Underactive Thyroid (Hypothyroidism) 528 1,792 55 2,375
Thyroiditis, Hashimoto's Disease, Autoimmune Disease 31 212 N/A 4 243
Enlarged Thyroid, Thyroid Nodules, Goiter 204 997 N/A 4 1,201
Other Thyroid Problem 113 169 N/A 4 282
Women's Health Disorder
Endometriosis N/A 2 1,694 N/A 2 1,694
Uterine Fibroids N/A 2 3,514 N/A 2 3,514
Benign Breast Disease (Fibroids, Cysts, Other) N/A 2 4,060 N/A 2 4,060
Pregnancy Induced High Blood Pressure,
Pre-Eclampsia, Toxemia or Eclampsia
N/A 2 103 N/A 2 103
Gestational Diabetes N/A 2 77 N/A 2 77
Autoimmune/Musculoskeletal Disorders
Rheumotoid Arthritis N/A 2 908 N/A 2 908
Lupus (SLE) N/A 2 110 N/A 2 110
Sjogren's Disease N/A 2 43 N/A 2 43
Scleroderma or Systemic Sclerosis N/A 2 32 N/A 2 32
Kidney Disorder
Kidney Stones 3,862 1,279 200 5,341
Kidney Disease or Kidney Failure 354 214 28 596
Digestive Disorder
Inflammatory Bowel Disease
(Chron's Disease, Ulcerative Colitis)
430 514 41 985
Skin Disorder
Vitiligo 130 84 N/A 4 214
Eczema 719 1,124 89 1,932
Psoriasis 821 582 76 1,479
Allergy to Bees, Wasps, or Other Insects 1,735 1,120 158 3,013
Optical or Hearing Disorder
Blindness 619 271 36 926
Nearsightedness 12,237 13,244 1,345 26,826
Farsightedness 13,683 11,673 1,217 26,573
Cataracts 3,427 2,965 199 6,591
Glaucoma 680 492 49 1,221
Detached Retina 358 179 30 567
Retinal or Macular Degeneration 391 368 34 793
Hearing Problems 11,781 N/A 3 913 12,694
Injury
Head Injury 6,623 1,556 726 8,905
Neck, Back, Spinal Cord Injury 6,250 2,198 588 9,036
Post-Polio Syndrome, Leg Injury 4,344 1,474 188 6,006
Neurologic Disorder
Epilepsy 123 127 N/A 4 250
Multiple Sclerosis 39 83 N/A 4 122
Parkinson's Disease 89 29 N/A 4 118
Tremor (Essential, Familial, Benign) 144 113 N/A 4 257

1 Numbers represent medical conditions reported during Phase II interviews. Because the asking of some questions was dependent on responses to earlier questions, the counts in this table reflect the numbers of each condition reported but not the total occurrence of the diseases in the cohort.

2 These conditions marked with N/A were not asked about in the men's health questions. Since 96 percent of private applicators and commercial applicators in the cohort are men, it would be misleading to report counts for these conditions in the private applicator column.

3 Hearing problems were not asked about in the women's health questions. Since 99.5 percent of spouses in the cohort are women, it would be misleading to report hearing problem counts in the spouse column.

4 These conditions occur in commercial applicators in insufficient numbers to be reported at this time.